Form #2103 Rev. 05/2011
Submit to:
SECRETARY OF STATE
Authentications Unit
P O Box 13550
Austin, TX 78711-3550
512-463-5705
Document Fee: $10
(up to $100 per child)
FOR USE IN PROCEEDINGS
RELATING TO THE
ADOPTION OF ONE OR
MORE CHILDREN
REQUEST FOR OFFICIAL
CERTIFICATE OR APOSTILLE—
ADOPTION PROCEEDINGS
Requesting Family
Name:
Address:
Street City State Zip
Phone: Email Address:
Have you made a prior authentication request for use in the same adoption proceedings?
Yes No If YES, Customer ID Number:
Number of Children Adopting: Name(s):
Consulate/Embassy/Country Where Document(s) Will Be Presented:
For Certified Records
Type of Record:
For Notarized Documents
Name of Notary:
Date Commission Expires: Number of Certificates/Apostilles Requested:
Execution
I certify that the requested authentication(s) is(are) for use in adoption proceedings for one or more children.
Date:
Signature of Requestor
Instructions
• Fee. The fee for an official certificate or apostille for use in a proceeding relating to the adoption of one or
more children is $10 per certificate or apostille up to $100 per child.
Fees may be paid by personal checks,
money
orders, LegalEase debit cards or American Express, Discover, MasterCard, and Visa credit cards.
Checks or money orders must be payable through a U.S. bank or financial institution and made payable to the
secretary of state. If paying by credit card, fees are subject to a statutorily
authorized convenience fee of 2.7
percent of the total fees, and Form 2101 must also be included.
• Multiple Requests. When requesting two or more certificates or apostilles, remit one payment for the total
amount. You must complete a separate form for each public official or notary public.
•
Materials and Return of Documents. The complete, original, certified record or notarized document to be
authenticated must be submitted with this form. If the authentication request concerns a translation, the
complete document includes both the notarized translation and the document being translated. The document,
fees, and form must be submitted with an appropriately sized self-addressed, postage pre-
paid envelope for
return of documents.
• Delivery. Materials may be delivered by mail to P.O. Box 13550, Austin, Texas 78711-3550 or by overnight
mail or hand delivery to Room 105, James Earl Rudder Office Building, 1019 Brazos, Austin, Texas 78701.
Hand-delivered documents are accepted weekdays
between the hours of 8:00 a.m. and 4:30 p.m.
Form 2103
